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Saturday, April 12, 2008

Boutique practices, retainer fees, concierge medicine

People often ask me about these so-called boutique practices (AKA: retainer fees, concierge medicine, patient financed medical care, etc.). I usually refer them to the SIMPD. The Society for Innovative Medical Practice Design (SIMPD) is an organization of physicians promoting a direct financial relationship with their patients. Translated = patients who are willing to pay for personalized health care can have more one-on-one time with their physicians by paying cash and bypassing insurance companies.

I think that's fine for patients who have that type of money. If doctors want to offer personalized services and cater to those who can afford it, so be it. However, in today's world, the leading cause of bankruptcy is healthcare bills. As the population ages, fewer can even keep up with the bills. Fewer patients can afford their medications. And, when people reach 65, they can hardly understand the instructions to sign up for all the appropriate Medicare plans. What does this say about our healthcare system?

Working adults (and non-working adults) face different types of struggles. Insurance premiums are escalating, and many have a difficult time keeping up with these rising costs. Consumer directed health plans (CDHP) are starting to get more popular for healthy patients who don't have any serious problems. Fewer physicians are accepting Medicaid, so those who accept Medicaid are getting all the patients in the area. Patients on Medicaid often can't afford medications, so now you have non-compliant patients all going to a single clinician. That clinician will never excel based on pay-for-performance standards since none of his/her patients are being compliant and reaching goal levels. So who gets punished for accepting Medicaid?

The entire system needs a serious overhaul. I wonder what American's health system will look like in a few years. Will these presidential candidates make a dent in the way healthcare is delivered? I guess we'll have to wait and see...